| NPI | 1104217017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: MS R887920) |
| Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant (Licence: MS R887920) |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2025-08-13 |